Nexalign iEXCHANGE

iEXCHANGE is a Web-based multi-payer solution that allows physicians and other health care providers to quickly and easily submit transactions to health care payers. It supports the direct processing of inpatient and outpatient authorizations, referrals, treatment updates, concurrent reviews and extensions. A simplified, smart solution for both administrative and clinical users, iEXCHANGE easily integrates into providers' existing workflows to make comprehensive information readily available and easily accessible.

In many cases iEXCHANGE can automate and approve up to 80 percent of referral requests, significantly reducing administrative procedures and related costs.  In addition, it gives provider staff real-time access to member eligibility and processed transaction information with appropriate considerations for member confidentiality. This increases the amount and accuracy of data that health plans receive and allows staff to spend more time on clinical management instead of administrative functions.

Providers, sign up for access to iEXCHANGE today.

Who Can Use iEXCHANGE:

• Hospitals: Patient access, admitting, ER, case managers
• Physician practices/clinics: Front-end staff, clinical staff
• Ancillary settings: Labs, transports, home health and more

iEXCHANGE Benefits:

• Reduces time and expense associated with paper, telephone, and fax processes.
• Automates the referral and authorization process, allowing payers to focus on high-risk, high-cost members.
• Identifies and routes pended cases to clinical reviewers for quick payer resolution.
• Multi-payer capabilities allow providers to submit requests to multiple payers with a consistent workflow experience, eliminating the need to train users on different payer technical systems.
• Expedites data entry process by defining practice- or department-specific defaults and drop-down lists.
• Increases patient satisfaction by streamlining payer communication.
• Facilitates more efficient processes, enabling staff to focus on patient care.

Provider Adoption and Deployment:

Payers deliver iEXCHANGE free to providers. It requires no provider investment and implementation is simple and straightforward. With its workflow-based approach, iEXCHANGE directly impacts pay-for-performance structures and care management programs and services. MEDecision's Center for Collaborative Health team provides deployment and adoption services for fast rollout.

MEDecision offers customized iEXCHANGE training sessions in a variety of formats, including Web-based classroom technologies, group-based classroom curriculums, on- site and telephonic. We continually evaluate provider activity and interactions with each health plan to identify when additional training is needed or when staff turnover occurs. Our goal is to drive frequent and effective iEXCHANGE use so organizations can realize its full potential.

iEXCHANGE transactions can be grouped into the following categories:

Creating New Requests: Allows providers to submit to payers requests for treatments to be performed (Inpatient Requests, Other [Outpatient] Requests, Referral Requests).

Creating New Notifications: Allows delegated providers to specify the status (Approved, Pended or Denied) of treatments provided.

Extending Existing Treatments: Allows providers to request the extension of an existing treatment.

Perform Various Searches: Treatment Search, Member Search, Patient Clinical Summary, Provider Search, Diagnosis Search, Procedure Search, Search for Inter-plan Requests

Treatment Updates: Notifies provider users of changes that have been made to Requests and Notifications submitted to Payers

Administrative Tasks: Delegated security model allows designated provider users to maintain user information and preferences: Group Administration, Account Administration, Submitting Providers, Frequent Providers, Diagnosis and Procedure Codes.

HIPAA Compliance and Security:

iEXCHANGE automatically translates all information to meet HIPAA compliance standards. Privacy is protected with the highest level of Internet-based security using Secure Socket Layer and 128-bit encryption.